Oral Immunotherapy

What is oral immunotherapy?

Oral immunotherapy (OIT) is the process of desensitizing a person who has a food allergy. We do this by having you ingest increasing amounts of the food you are allergic to under the guidance of medical professionals. This retrains your immune system to no longer react to that food.

There are two separate end goals of OIT:

• Not experiencing a reaction if you are accidentally exposed to your allergen
• Being able to freely eat meals and foods without needing to look for or ask about your allergen

Your OIT regimen will differ in length and maintenance depending on which goal you are hoping to achieve.

Are you or your loved one a candidate for oral immunotherapy?

OIT is an option for people of all ages with a wide range of food allergies (though it is most successful in children). We regularly offer OIT for peanut, tree nut, sesame, egg and milk allergies. If you are allergic to another food and you are interested in OIT, please contact our office to discuss your eligibility.

If you have other allergic conditions (such as asthma, allergic rhinitis or atopic dermatitis), they will need to be well controlled prior to the start of your OIT. Individuals with a history of eosinophilic esophagitis (an inflammatory condition affecting the esophagus) are not eligible for OIT.

What does the oral immunotherapy process include?

The first step in the process involves confirming your allergy. This will be done by either reviewing your history of allergic reactions and conducting a blood or skin test or through a food challenge (which involves you eating the food you are thought to be allergic to while being monitored for a reaction).

Once your allergy is confirmed, you will come for another appointment to review the OIT process in detail. At this time, our clinicians also will make sure that your other allergic diseases are well controlled (if applicable) before the first step of your OIT regimen.

The first treatment is known as the initial dose escalation. At this appointment, you will start by eating a very small amount of the food you are allergic to. Then, you will eat increasing quantities of the food every 20 minutes, approximately 10 times. After eating the last dose and being monitored for an hour, you will return home.

For at least seven days after your first appointment, you will eat your last tolerated dose once a day at home. At your next appointment, your dose will be increased incrementally (this is known as updosing).

The updosing cycle will continue for several months until you reach a pre-determined level based on your selected goal for OIT. Based on that goal and your age, your allergist will recommend a specific maintenance dose for you to continue taking at home, a personalized follow-up care plan and additional food challenges to test your tolerance level.